Efficacy of an orally administered anti-diarrheal probiotic paste (Pro-Kolin Advanced) in dogs with acute diarrhea: A randomized, placebo-controlled, double-blinded clinical study

Nixon, Sophie L.; Rose, Lindsay; Muller, Annika T.

Recent evidence suggests that the fecal microbiome is altered in dogs with acute diarrhea, [8] [9] [10] identifying modulation of the microbiome as a potential therapeutic target. Probiotics and prebiotics are defined as live microorganisms that confer a health benefit to the host when delivered in adequate amounts 11 and substrates that selectively promote the growth of microorganisms that confer a health benefit, 12 respectively. There is evidence that probiotics and prebiotics are capable of altering the microbiome of dogs. [13] [14] [15] [16] [17] [18] [19] [20] Probiotics and prebiotics favorably modulate gastrointestinal health by diverse mechanisms, but few studies have investigated the mechanism of action of putative probiotics in dogs. [21] [22] [23] [24] [25] [26] In predominantly in vitro, ex vivo, and rodent studies, probiotics and prebiotics have been shown to inhibit the growth of gastrointestinal pathogens, [27] [28] [29] [30] [31] [32] to improve gastrointestinal barrier function, and to favorably modulate the immune system. [33] [34] [35] [36] The extent to which these findings can be extrapolated to dogs is unknown. There is growing evidence in both the human and veterinary medical fields for the therapeutic potential of probiotics and prebiotics in treating and preventing acute diarrhea. A meta-analysis of 63 studies found that the administration of probiotics shortened the duration of clinical signs and decreased stool frequency in acute infectious diarrhea in humans. 37 44 Despite a lack of evidence for strain E. faecium 4b1707 in the treatment of acute diarrhea in dogs, antidiarrheal probiotic pastes (ADPPs) containing this probiotic are available. Our aim was to characterize the effect of a commercially available ADPP containing E. faecium 4b1707 (Pro-Kolin Advanced; PKA) on the clinical outcome of dogs with acute diarrhea. Specifically, we sought to identify whether the ADPP was associated with a shorter duration of acute diarrhea and a decrease in the number of dogs requiring additional medical intervention (AMI).